N Moshina1, S Sagstad2, S Sebuødegård3, G G Waade4, E Gran5, J Music6, S Hofvind7. 1. Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304, Oslo, Norway. Electronic address: Nataliia.Moshina@kreftregisteret.no. 2. Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304, Oslo, Norway. Electronic address: Silje.Sagstad@kreftregisteret.no. 3. Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304, Oslo, Norway. Electronic address: Sofie.Sebuodegard@kreftregisteret.no. 4. Oslo Metropolitan University, P.O. 4, St. Olavs Plass, 0130, Oslo, Norway. Electronic address: Gunvor.Waade@kreftregisteret.no. 5. Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway. Electronic address: Evy.Gran@ahus.no. 6. Akershus University Hospital, Sykehusveien 25, 1478, Lørenskog, Norway. Electronic address: Jasmina.Music@ahus.no. 7. Cancer Registry of Norway, P.O. 5313 Majorstuen, 0304, Oslo, Norway; Oslo Metropolitan University, P.O. 4, St. Olavs Plass, 0130, Oslo, Norway. Electronic address: Solveig.Hofvind@kreftregisteret.no.
Abstract
INTRODUCTION: We aimed to investigate the association between breast compression and experienced pain during mammographic screening. METHODS: Using a questionnaire, we collected information on pain experienced during mammography from 1155 women screened in Akershus, February-March 2018, as a part of BreastScreen Norway. The questionnaire provided information on pain using a numeric rating scale (NRS, 0-10) and related factors. Data on compression force (Newton, N), pressure (kilopascal, kPa) and breast characteristics were extracted from the DICOM-header and a breast density software. Log-binomial regression was used to determine the relative risk (RR) of severe versus mild/moderate experienced pain associated with compression parameters, adjusting for breast characteristics and related factors. RESULTS: Mean score of experienced pain was 2.2, whereas 6% of the women reported severe pain (≥7) during the examination. High body mass index (BMI) (≥27.3 kg/m2) was associated with a higher RR of pain scores ≥7 (RR 1.86, 95%CI 1.02-3.36) compared to medium BMI (23.7-27.2 kg/m2). Low compression pressure (4.0-10.2 kPa) was associated with a higher RR of severe pain (RR 2.93, 95%CI 1.39-6.20), compared with medium compression pressure (10.3-13.5 kPa) after adjusting for contact area, age, compressed breast thickness, volumetric breast density and BMI. The risk of severe versus mild/moderate pain (≥7 versus <7) decreased by 2% with increasing compression force (RR 0.98, 95%CI 0.97-1.00). CONCLUSION: Women reported low levels of pain during mammography. Further knowledge about factors affecting experienced pain is needed to personalize the examination to the individual woman. IMPLICATIONS FOR PRACTICE: Pain in shoulder(s) and/or neck prior to screening should be considered by the radiographers in a practical screening setting. A compression force of 100-140 N and pressure of 10.3-13.5 kPa are acceptable with respect to reported pain during mammography.
INTRODUCTION: We aimed to investigate the association between breast compression and experienced pain during mammographic screening. METHODS: Using a questionnaire, we collected information on pain experienced during mammography from 1155 women screened in Akershus, February-March 2018, as a part of BreastScreen Norway. The questionnaire provided information on pain using a numeric rating scale (NRS, 0-10) and related factors. Data on compression force (Newton, N), pressure (kilopascal, kPa) and breast characteristics were extracted from the DICOM-header and a breast density software. Log-binomial regression was used to determine the relative risk (RR) of severe versus mild/moderate experienced pain associated with compression parameters, adjusting for breast characteristics and related factors. RESULTS: Mean score of experienced pain was 2.2, whereas 6% of the women reported severe pain (≥7) during the examination. High body mass index (BMI) (≥27.3 kg/m2) was associated with a higher RR of pain scores ≥7 (RR 1.86, 95%CI 1.02-3.36) compared to medium BMI (23.7-27.2 kg/m2). Low compression pressure (4.0-10.2 kPa) was associated with a higher RR of severe pain (RR 2.93, 95%CI 1.39-6.20), compared with medium compression pressure (10.3-13.5 kPa) after adjusting for contact area, age, compressed breast thickness, volumetric breast density and BMI. The risk of severe versus mild/moderate pain (≥7 versus <7) decreased by 2% with increasing compression force (RR 0.98, 95%CI 0.97-1.00). CONCLUSION:Women reported low levels of pain during mammography. Further knowledge about factors affecting experienced pain is needed to personalize the examination to the individual woman. IMPLICATIONS FOR PRACTICE: Pain in shoulder(s) and/or neck prior to screening should be considered by the radiographers in a practical screening setting. A compression force of 100-140 N and pressure of 10.3-13.5 kPa are acceptable with respect to reported pain during mammography.